Diagnosis of Dupuytren’s Contracture
The diagnosis of Dupuytren’s contracture is typically made through a physical examination. No specialised tests or imaging are required in most cases. Doctors can often recognise the condition by inspecting the hand and feeling the thickened cords or nodules under the skin. A clear visual inspection, along with a simple functional test, is usually enough to confirm the presence of Dupuytren’s contracture.
One of the most common diagnostic tools is the “tabletop test.” In this test, the patient is asked to lay their hand flat on a surface, such as a table. If one or more fingers cannot lie flat due to tightening of the cords in the palm, this suggests a positive result and indicates moderate to advanced Dupuytren’s contracture. While early stages may not interfere with hand function, this test helps determine when intervention may be needed.
Doctors also assess the progression by checking which fingers are involved, how much movement has been lost, and whether the affected tissue is still soft or has hardened. The presence of nodules, skin dimpling, and fixed flexion deformities are noted. All of these are signs that the condition is evolving and may require further monitoring or treatment.
In most cases, no X-rays, MRIs, or blood tests are necessary. However, if other hand conditions are suspected—such as arthritis, tendon injuries, or nerve entrapments—imaging may be ordered to rule them out. The diagnosis of Dupuytren’s contracture must also be distinguished from other causes of hand contractures, like trigger finger or scleroderma, which may appear similar but require different treatment.
For patients with bilateral involvement (both hands), or a strong family history, the doctor may inquire about additional fibromatoses elsewhere in the body. These can include plantar fibromatosis (in the feet) or Peyronie’s disease (in men), which are sometimes linked genetically.
Diagnosis of Dupuytren’s Contracture
In South Africa, diagnosis is usually made by general practitioners or orthopaedic specialists. While most private clinics can offer a swift diagnosis, patients in public healthcare or rural settings may experience delays in referral or specialist access. Awareness of the condition among general health workers is therefore key to improving early diagnosis rates.
Once the diagnosis of Dupuytren’s contracture is confirmed, treatment decisions depend on severity, progression, and the patient’s functional needs. Not every case requires immediate intervention. Many individuals live with mild forms of the condition without significant impact on their daily activities.
Accurate and timely diagnosis is vital, as early identification allows patients to monitor changes and prepare for possible treatments. With early guidance, patients can make informed decisions and seek care before hand function becomes seriously impaired.
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